Phillips, Traci N

Phillips, Traci N is an individual health care provider with primary practice located at 3000 Mack Rd Ste 120, Fairfield OH 45014-5335. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Phillips, Traci N can be contacted via phone (513) 682-6975.

Contact Information

Primary practice address
3000 Mack Rd Ste 120 Fairfield OH 45014-5335
Phone: (513) 682-6975
Fax: (513) 682-6976
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X COA.13933-NP Ohio

Profile Details

NPI number 1225381833
LBN Legal business name Phillips, Traci N
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2012
Last updated May 3rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225381833 NPPES
Ohio MEDICAID 0079955

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